|
17-hydroxypregnenolone
|
$72.75 |
$72.75 |
$72.75 |
$85.15
|
|
3d ech img cgen car anomal
|
$2,863.16 |
$2,863.16 |
$2,863.16 |
$669.00
|
|
3-d radiotherapy plan
|
$3,018.64 |
$3,018.64 |
$3,018.64 |
$4,886.50
|
|
5' nucleotidase - sendout
|
$9.37 |
$9.37 |
$9.37 |
$50.05
|
|
88334 ap bill cytologic exam each additional site
|
$653.60 |
$653.60 |
$653.60 |
$97.65
|
|
Abdominal CT scan (with and without contrast)
|
$13,960.50 |
$13,960.50 |
$13,960.50 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$13,139.31 |
$13,139.31 |
$13,139.31 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$11,825.95 |
$11,825.95 |
$11,825.95 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$10,439.28 |
$10,439.28 |
$10,439.28 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$6,110.71 |
$6,110.71 |
$6,110.71 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$3,515.46 |
$3,515.46 |
$3,515.46 |
$1,972.66
|
|
Ablate heart dysrhythm focus
|
$18,799.85 |
$18,799.85 |
$18,799.85 |
$10,008.58
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$25.42 |
$25.42 |
$25.42 |
$125.63
|
|
Acetaminophen level
|
$2,351.17 |
$2,351.17 |
$2,351.17 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$80.73 |
$80.73 |
$80.73 |
$133.60
|
|
Acetone qualitative
|
$601.93 |
$601.93 |
$601.93 |
$47.45
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$227.27 |
$227.27 |
$227.27 |
$323.77
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$39.70 |
$39.70 |
$39.70 |
$42.28
|
|
Acute hepatitis panel
|
$456.75 |
$456.75 |
$456.75 |
$284.70
|
|
Adenovirus antibody,serum - quest
|
$12.00 |
$12.00 |
$12.00 |
$63.00
|
|
Adh-sendout
|
$14.66 |
$14.66 |
$14.66 |
$109.28
|
|
Administration immunization each additional vaccine
|
$406.83 |
$406.83 |
$406.83 |
$46.23
|
|
Administration vaccine influenza virus
|
$23.37 |
$23.37 |
$23.37 |
$49.50
|
|
Adrenal cortex & medulla img
|
$1,733.40 |
$1,733.40 |
$1,733.40 |
$1,780.19
|
|
_afb org id by sequencing rflx ast-sendout
|
$65.00 |
$65.00 |
$65.00 |
$289.60
|
|
Albumin body fluid quantitative each specimen
|
$38.40 |
$38.40 |
$38.40 |
$48.00
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$38.40 |
$38.40 |
$38.40 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$524.44 |
$524.44 |
$524.44 |
$43.50
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$1,647.89 |
$1,647.89 |
$1,647.89 |
$93.60
|
|
Alkaline phosphatase
|
$989.33 |
$989.33 |
$989.33 |
$46.20
|
|
Allergen egg white ige
|
$6.90 |
$6.90 |
$6.90 |
$41.00
|
|
Allergen specific ige qual multi scrn ea
|
$7.66 |
$7.66 |
$7.66 |
$26.95
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$12,965.22 |
$12,965.22 |
$12,965.22 |
$2,513.00
|
|
Alt/sgpt
|
$587.06 |
$587.06 |
$587.06 |
$49.00
|
|
Aluminum - quest
|
$19.23 |
$19.23 |
$19.23 |
$87.00
|
|
Alys cplx sp/pn npgt w/prgrm
|
$3,019.54 |
$3,019.54 |
$3,019.54 |
$437.50
|
|
Amino acid screen, urine
|
$12.55 |
$12.55 |
$12.55 |
$64.28
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$37.33 |
$37.33 |
$37.33 |
$42.84
|
|
Aminolevulinic acid delta
|
$141.30 |
$141.30 |
$141.30 |
$87.12
|
|
Amitriptyline (elavil) -sendout
|
$14.66 |
$14.66 |
$14.66 |
$101.17
|
|
Ammonia
|
$1,472.06 |
$1,472.06 |
$1,472.06 |
$120.90
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$303.98 |
$303.98 |
$303.98 |
$130.08
|
|
Ana ds-dna
|
$17.48 |
$17.48 |
$17.48 |
$65.52
|
|
Analysis gene f2 20210g>a variant
|
$28.51 |
$28.51 |
$28.51 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$26.06 |
$26.06 |
$26.06 |
$226.60
|
|
Anca screen with reflex to titer -quest
|
$16.10 |
$16.10 |
$16.10 |
$109.20
|
|
Anodyne therapy charges pt
|
$949.43 |
$949.43 |
$949.43 |
$41.02
|
|
Anora (draw only)
|
$15.00 |
$15.00 |
$15.00 |
$36.00
|
|
Antibody bacterium, not elsewhere specified
|
$80.50 |
$80.50 |
$80.50 |
$57.89
|
|
Antibody elution rbc reference
|
$112.00 |
$112.00 |
$112.00 |
$176.54
|
|
Antibody htlv-i
|
$82.80 |
$82.80 |
$82.80 |
$48.75
|
|
Antibody htlv-ii
|
$82.80 |
$82.80 |
$82.80 |
$35.22
|
|
Antibody tetanus
|
$22.47 |
$22.47 |
$22.47 |
$61.98
|
|
Antinuclear antibodies
|
$3.00 |
$3.00 |
$3.00 |
$91.70
|
|
Antinuclear antibodies titer
|
$6.68 |
$6.68 |
$6.68 |
$80.25
|
|
Antistreptolysin o screen
|
$74.94 |
$74.94 |
$74.94 |
$59.40
|
|
Antithrombin iii activity
|
$75.35 |
$75.35 |
$75.35 |
$115.23
|
|
Apheresis plasma
|
$1,844.77 |
$1,844.77 |
$1,844.77 |
$3,411.50
|
|
Apheresis platelets
|
$1,844.77 |
$1,844.77 |
$1,844.77 |
$2,345.00
|
|
Apheresis rbc
|
$1,691.04 |
$1,691.04 |
$1,691.04 |
$3,348.50
|
|
Apheresis wbc
|
$1,691.04 |
$1,691.04 |
$1,691.04 |
$3,342.71
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$422.55 |
$422.55 |
$422.55 |
$75.98
|
|
Artery xray of abdomen 75726-26
|
$13,158.34 |
$13,158.34 |
$13,158.34 |
$4,337.45
|
|
Artery x-rays adrenals
|
$17,472.79 |
$17,472.79 |
$17,472.79 |
$3,706.68
|
|
Artery x-rays chest
|
$25,439.80 |
$25,439.80 |
$25,439.80 |
$2,587.20
|
|
Artery xrays of pelvis 75736 26
|
$19,573.05 |
$19,573.05 |
$19,573.05 |
$4,086.49
|
|
Artery x-rays spine
|
$12,712.91 |
$12,712.91 |
$12,712.91 |
$4,306.40
|
|
Assay acid phosphatase
|
$89.68 |
$89.68 |
$89.68 |
$38.22
|
|
Assay of adp & amp
|
$18.59 |
$18.59 |
$18.59 |
$127.40
|
|
Assay of interleukin-6 (il-6)
|
$54.00 |
$54.00 |
$54.00 |
$77.35
|
|
Assay of procainamide w/metab
|
$14.78 |
$14.78 |
$14.78 |
$61.20
|
|
Assay of sialic acid
|
$11.33 |
$11.33 |
$11.33 |
$60.45
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$822.46 |
$822.46 |
$822.46 |
$49.80
|
|
Ast/sgot
|
$587.06 |
$587.06 |
$587.06 |
$45.65
|
|
Atropine 0.1 mg/ml injection syringe
|
$15.94 |
$15.94 |
$15.94 |
$43.01
|
|
Azathioprine 50 mg tablet
|
$14.18 |
$14.18 |
$14.18 |
$6.76
|
|
Bactericidal level serum
|
$121.28 |
$121.28 |
$121.28 |
$82.50
|
|
Bcg live 50 mg intravesical suspension
|
$640.47 |
$640.47 |
$640.47 |
$517.26
|
|
Belt ostomy lg 34-65in
|
$7.31 |
$7.31 |
$7.31 |
$5.20
|
|
#_benzodiazconfur
|
$11.54 |
$11.54 |
$11.54 |
$99.72
|
|
Benztropine 1 mg/ml injection solution
|
$186.30 |
$186.30 |
$186.30 |
$121.88
|
|
Beta-2 microglobulin
|
$169.88 |
$169.88 |
$169.88 |
$84.66
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$217.35 |
$217.35 |
$217.35 |
$75.12
|
|
Bilirubin direct
|
$1,048.94 |
$1,048.94 |
$1,048.94 |
$49.29
|
|
Bld prd mix
|
$432.08 |
$432.08 |
$432.08 |
$139.21
|
|
Blood Clotting (PT/INR) Test
|
$2,264.75 |
$2,264.75 |
$2,264.75 |
$51.35
|
|
Blood Clotting (PTT) Test
|
$2,431.61 |
$2,431.61 |
$2,431.61 |
$72.15
|
|
Blood Count (CBC) Test (without differential)
|
$742.01 |
$742.01 |
$742.01 |
$62.28
|
|
Blood Culture Test
|
$2,386.65 |
$2,386.65 |
$2,386.65 |
$144.65
|
|
Blood gases o2 saturation direct measurement
|
$3,578.86 |
$3,578.86 |
$3,578.86 |
$220.35
|
|
Blood gases ph venous
|
$393.36 |
$393.36 |
$393.36 |
$63.70
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$634.71 |
$634.71 |
$634.71 |
$33.57
|
|
Blood occult peroxidase activity qualitative gastric
|
$235.70 |
$235.70 |
$235.70 |
$33.57
|
|
Blood smear microscopic w manual differential wbc count
|
$634.71 |
$634.71 |
$634.71 |
$37.44
|
|
Blood typing rh (d)
|
$295.03 |
$295.03 |
$295.03 |
$56.24
|
|
Bone imaging multiple areas
|
$11,422.16 |
$11,422.16 |
$11,422.16 |
$1,147.57
|
|
Bone/joint imaging ltd area
|
$9,835.40 |
$9,835.40 |
$9,835.40 |
$1,151.16
|
|
(both sides) smear without diff wbc count
|
$205.60 |
$205.60 |
$205.60 |
$33.57
|
|
Bowel imaging
|
$4,851.59 |
$4,851.59 |
$4,851.59 |
$1,186.25
|
|
Brace back epic lso 637
|
$1,075.36 |
$1,075.36 |
$1,075.36 |
$1,244.20
|
